Haloperidol ...

[rninme]

I had an acutely psychotic patient with an order for IV Haloperidol....

I went to the pyxis...selected haloperidol lactate...it dispensed the med. In reading the vial, it stated "FOR IM ADMINISTRATION ONLY". Great...I thought I had selected the wrong medication...checked the screen...dispensed med was haloperidol lactate. So, I called the doctor and got the route changed to IM administration instead. I emailed pharmacy and told them of the potential problem. The reply I got was...it is ok to use for IV administration. WHAT??!! The vial states NOT FOR IV ADMINISTRATION, FOR IM ADMINISTRATION ONLY!!!! I am NOT GOING TO GIVE IT IV!

HELP:uhoh3: !!! Is this RPh nuts?? I've checked drug guides, the FDA website...anywhere and everywhere....and I can't find a clear answer, so any help you can give me would be greatly appreciated!!!

[LilRedRN1973]

I work in an ICU and we use Haldol IV all the time. It's one of the more frequently ordered drug for severe agitation when ativan/versed, etc. are not effective. Usually the order will read 5mg Haldol IV Q 1 hour. The vials we use say "For IM use only". I've questioned this as well in my unit only to hear "it's always been given". I do monitor my patients for changes in the QT interval and have seen Haldol significantly prolong the QT interval.

Melanie = )

[barbyann]

The manufacturer is covering his butt by putting IM only on the vial. The hospital is covering their butt by making policies in regards to Haldol IV. And yet I still see nurses give Haldol IV "cause thats what the MD ordered" "the Pharmacist said it was OK". Protect yourself, always.

I don't think off label use would be a consideration for this route override issue. Therapeutic effect/desired effect is the same just more timely IV. Risk vs. benefit, how much risk are you willing to take?